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Background: Female reproductive system perturbations may decrease a woman's likelihood of conceiving and carrying her baby to term, influence the future life course of a viable infant, and may also reflect and have an impact on her own gynecological and general health and well-being. This chapter surveys effects of persistent organic compounds (POCs) and other less persistent but often pervasive bioactive organic compounds (BOCs) on these health outcomes. Objectives: To present an overview that highlights evidence gathered from studies and reviews, and to provide readers with background to interpret results of future studies. Results: This chapter provides an overview of human BOC and POC research methods, issues, and findings pertaining to women's reproductive and offspring's developmental effects of exposure. Research gaps and additional information resources are also highlighted. Discussion: Human evidence is mounting for adverse intrauterine exposure effects of (1) polychlorinated biphenyls (particularly estrogenic congeners) on lowered birth weight; (2) phthalates on testicular dysgenesis syndrome; (3) various solvents on fetal loss; (4) smoking on altered reproductive hormone levels, lowered fertility, fecundity, birth weights, and menopausal age, and increased stillbirths, cleft lip malformations, and maternal (diastolic) hypertension; and (5) pesticides on childhood leukemia. There are strikingly few studies of other BOCs and POCs and reproductive outcomes, considering how many of these compounds are prevalent and that their potential effects and comorbidities may be severe with impacts across the life span. Conclusions: Evidence of adverse female reproductive and developmental effects is mounting for some BOCs and POCs but is sparse for many others. Well-designed longitudinal human studies are needed.